An instance of one-sideness bias

Let us consider the following (in deductive form) instance of the one-sidedness bias, mentioned by Philippe Boulanger (2000, p. 3)1. Ulam estimates that if a company were to achieve a level of workforce large enough, its performance would be paralysed by the many internal conflicts that would result. Ulam estimates that the number of conflicts between people would increase according to the square of the number n of employees, while the impact on the work that would result would only grow as a function of n. Thus, according to this argument, it is not desirable that the number of employees within a company becomes important. However, it turns out that Ulam’s reasoning is fallacious, as Boulanger points it out, for it focuses exclusively on the conflictual relations between employees. But the n2 relationships among the company employees can well be confrontational, but may include as well collaborative relationships that are quite beneficial for the company. And so there is no reason to favour conflictual relationships with respect to collaborative ones. And when among n2 relationships established between the company employees, some are genuine collaborative relationships, the effect is, instead, of improving business performance. Therefore, we can not legitimately conclude that it is not desirable that the workforce of a company reaches a large size.

Ulam’s reasoning can be described as follows:

Fig3

(1Ā ) if <a company has a large workforce>
(2Ā ) then <n2 conflictual relationships will result>
(3Ā ) then negative effects will result
(4Ā ) ∴ the fact that <a company has a large workforce> is bad

This type of reasoning has the structure of a one-sidedness bias, since it focuses only on conflicting relationships (the dissociation pole of the association/dissociation duality), by ignoring a parallel argument with the same structure that could legitimately be raised, focusing on collaborative relationships (the association pole), which is the other aspect relevant to this particular topic. This parallel argument goes as follows:

fig-inv-250

(1A) if <a company has a large workforce>
(2A) then <n2 collaborative relationships will result>
(3A) then positive effects will result
(4A) ∴ the fact that <a company has a large workforce> is good

This finally casts light on how the two formulations of the argument lead to conflicting conclusions, i.e. (4Ā) and (4A). At this point, it is worth noting the very structure of the conclusion of the above reasoning:

(5Ā ) the situation s is bad from the viewpoint of Ā (dissociation)

while the conclusion of the parallel reasoning is as follows:

(5A) the situation s is good from the viewpoint of A (association)

But if the reasoning had been complete, by taking into account the two points of view, a different conclusion would have ensued:

Fig1

(5Ā ) the situation s is bad from the viewpoint of Ā (dissociation)
(5A) the situation s is good from the viewpoint of A (association)
(6A/Ā) the situation s is bad from the viewpoint of Ā (dissociation) and good from the viewpoint of A (association)
(7A/Ā) the situation s is neutral from the viewpoint of the duality A/Ā (association/dissociation)

And such a conclusion turns out to be quite different from that resulting from (5Ā ) and (5A).

line-1

Further reading: Elements of dialectical contextualism

1Philippe Boulanger says (personal correspondence) that he heard Stanislaw Ulam develop this particular point in a conference at the University of Colorado.

 This text is part of a book under construction. (c) Paul Franceschi
Posted in blog | Leave a comment

Dual poles

fig2The dual poles can de defined as neutral concepts, which come in pairs, and are such that each of them is defined as the opposite of the other. For example, internal can be defined as the opposite of external and symmetrically, external can be defined as the contrary of internal. In a sense, there is no primitive notion here and neither A nor Ā of the dual poles can be regarded as the primitive notion.

Examples of dual poles are: static, dynamic, internal, external, qualitative, quantitative, absolute, relative, diachronic, synchronic, etc..

The dual poles are neutral concepts, as well as simple qualities. They also differ from vague notions.

The dual poles are neutral concepts, i.e. concepts that present no ameliorative or pejorative nuance. In this sense, external, internal, concrete, abstract, etc.., are dual poles, unlike concepts such as beautiful, ugly, brave, which present either a ameliorative or pejorative shade, and are therefore non-neutral, since beautiful has a positive connotation and ugly has a pejorative connotation.

The dual poles of a given duality correspond to simple qualities, as opposed to composite qualities​​.

Dual poles are also different from vague objects. Dual poles and vague objects, first, have certain properties in common. Indeed, vague objects come in pairs in the same way as dual poles. Moreover, vague concepts are classically considered as having an extension and an anti-extension, which are mutually exclusive. Such a feature is also shared by the dual poles.
A first difference between dual poles and vague concepts (i) lies in the fact that the union of the extension and the anti-extension of vague concepts is not exhaustive in the sense that they admit of borderline cases (and also borderline cases of borderline cases, etc., giving rise to a hierarchy of higher-order vagueness of order n), which is a penumbra zone. Conversely, the dual poles do not necessarily have such a characteristic. Indeed, the union of the dual poles can be either exhaustive or non-exhaustive. For example, the abstract/concrete duality is then intuitively exhaustive, since there does not seem to exist any objects that are neither abstract nor concrete. The same goes for the vague/precise duality: intuitively, there does no exist indeed objects that are neither vague nor precise, and that would belong to an intermediate category. Hence, there are dual poles whose extension and anti-extension turns out to be exhaustive, unlike vague concepts, such as the two poles of the abstract/concrete duality.
It is worth mentioning, second, another difference (ii) between dual poles and vague objects. In effect, dual poles are simple qualities, while vague objects may consist of simple or compound qualities. There exist indeed some vague concepts which are termed multi-dimensional vague objects, such as the notion of vehicle, of machine, etc..
A final difference between the two categories of objects (iii) lies in the fact that some dual poles have an inherently precise nature. This is particularly the case of the individual/collective duality, which is susceptible to give rise to a very accurate definition.

Further reading: Elements of dialectical contextualism

 This text is part of a book under construction. (c) Paul Franceschi
Posted in Glossary | Leave a comment

Dialectical monism in Aztec philosophy

224px-Dualmasktlatilco

It is worth mentioning a form of dialectical monism in the ancient Aztec philosophy and especially in the concept of ” Teotl “, which is at the center of Aztec metaphysics and cosmology. Teotl is the expression of an endless alternation of continuous and cyclical oscillation between opposite poles. Teotl is thus characterized by a dual prominent structure, which results from the union of opposites , themselves characterized by complementarity. The dual pairs involved include : the masculine and the feminine, dark and light, order and disorder, hot and cold, life and death, being and non-being etc. The interdependence and higher union of the principles of life and death in Teotl, for example, was represented by Aztec artists of Tlatilco and Oaxaca in masks where one half is alive while the other half died, revealing the skull bones.

Reference: James Maffie, Aztec Philosophy, Internet Encyclopedia of Philosophy

Related notions: Dialectical monism in Heraclitus

 This text is part of a book under construction. (c) Paul Franceschi
Posted in Glossary | Tagged , , , , , , , , , | Leave a comment

Dialectical monism in Heraclitus

488px-Hendrik_ter_Brugghen_-_Heraclitus

In the antique Western world, dialectical monism appears not much widespread. But we notably find an elaborate form of dialectical monism in Heraclitus. Several fragments of the philosophy of Heraclitus reflect the expression of this unity that results from the joint presence of two dual principles. For example, the Eigth fragment:

What opposes unites, and the finest attunement stems from things bearing in opposite directions, and all things come about by strife.

and also the Tenth fragment:

Things grasped together: things whole, things not whole; being brought together, being separated; consonant, dissonant. Out of all things one thing, out of one thing all things.

Here we find the expression of dialectical monism , through the union of opposites . We see how the dialectic proceeds from the union of opposites : the consonant and dissonant . This dialectical approach that underpins the philosophy of Heraclitus is also illustrated in Fragment 51:

They do not understand how, while differing from it is in agreement with itself. There is a back turning connection, like that of a bow or a lyre.

This text is part of a book under construction. (c) Paul Franceschi
Credits: Illustration from Wiki commons
Posted in Glossary | Leave a comment

Dualities

dual-largeDualities are pair of neutral concepts which come in pairs, such as each of the two concepts is the opposite of the other.

We can denote a given duality by A/Ā, A and Ā begin the two opposite concepts, which are termed dual poles.

Examples of dualities include: Internal/External, Quantitative/Qualitative, Visible/Invisible, Absolute/Relative Abstract/Concrete, Static/Dynamic, Diachronic/Synchronic, Single/Multiple, Extension/Restriction, Aesthetic/Practical, Precise/Vague, Finite/Infinite, Single/Compound, Individual/Collective, Analytical/Synthetic, Implicit/Explicit, Voluntary/Involuntary

Posted in Glossary | Leave a comment

Dichotomous analysis applied to paradox resolution

dichoThe dichotomous analysis as a methodology that can be used to search for solutions to some paradoxes and philosophical problems, results from the statement of the principle of dialectical indifference. The general idea underlying the dichotomous approach to paradox analysis is that two versions, corresponding to one and the other pole of a given duality, can be untangled within a philosophical paradox. The corresponding approach then is to find a reference class which is associated with the given paradox and the corresponding duality A/Ā, as well as the two resulting variations of the paradox that apply to each pole of this duality.

However, every duality is not well-suited to this approach, as for many dualities, the corresponding version of the paradox remains unchanged, regardless of the pole under consideration. In the dichotomous method, one focuses on finding a reference class and a relevant associated duality, such that the viewpoint of each of its poles actually lead to two structurally different versions of the paradox , or the disappearance of paradox from the point of view of one of the poles. Thus, when considering the paradox in terms of two poles A and Ā, and if it has no effect on the paradox itself, the corresponding duality A/Ā reveals itself therefore, from this point of view, irrelevant.

Further reading: Elements of dialectical contextualism

Posted in Glossary | Tagged , , , , , , | Leave a comment

Viewpoint of a pole

Fig3Let us define the concept of point of view related to a given pole of an A/Ā duality: we get then, for example (at the level of the extension/restriction duality) the standpoint by extension, as well as the viewpoint by restriction. Similarly, the qualitative viewpoint or perspective results from it, as well as the quantitative point of view, etc.. (at the level of the qualitative/quantitative duality). Thus, when considering a given object o (either a concrete or an abstract object such as a proposition or a reasoning), we may consider it in relation to various dualities, and at the level of the latter, relative to each of its two dual poles.

The underlying idea inherent to the viewpoint relative to a given duality, or to a given pole of a duality, is that each of the two poles of the same duality, all things being equal, deserve an equal legitimacy. In this sense, if we consider an object o in terms of a duality A/Ā, one should not favour one of the poles with respect to the other. To obtain an objective point of view with respect to a given duality A/Ā, one should place oneself in turn from the perspective of the pole A, and then from that of the pole Ā. For an approach that would only address the viewpoint of one of the two poles would prove to be partial and truncated. The fact of considering in turn the perspective of the two poles, in the study of an object o and of its associated reference class allows to avoid a subjective approach and to meet as much as possible the needs of objectivity.

Further reading: Elements of dialectical contextualism

(c) Paul Franceschi

Posted in Glossary | Tagged , , , , , , , | Leave a comment

Principle of dialectical indifference

617px-Gleicharmige_Waage

(Illustration from Wikimedia commons)

(PRINCIPLE OF DIALECTICAL INDIFFERENCE) When considering a given object o and the reference class E associated with it, from the angle of duality A/Ā, all things being equal, it should be given equal weight to the viewpoint of the A pole and the viewpoint of the Ā pole.

The principle of dialectical indifference can be enunciated as follows: if we consider an object o under the angle of a given A/Ā duality, there is no reason to favour the viewpoint from A with regard to the viewpoint from Ā, and unless otherwise resulting from the context, we must weigh equally the viewpoints A and Ā. A direct consequence of this principle is that if one considers the perspective of the A pole, one also needs to take into consideration the standpoint of the opposite pole Ā (and vice versa). The need to consider both points of view, the one resulting from the A pole and the other associated with the Ā pole, meets the need of analysing the object o and the reference class associated with it from an objective point of view. This goal is achieved, as far as possible, by taking into account the complementary points of view which are those of the poles A and Ā. Each of these viewpoints has indeed, with regard to a given duality A/Ā, an equal relevance. Under such circumstances, when only the A pole or (exclusively) the pole Ā is considered, it consists then of a one-sided perspective. Conversely, the viewpoint which results from the synthesis of the standpoints corresponding to both poles A and Ā is of a two-sided type. Basically, this approach proves to be dialectical in essence. In effect, the step consisting of successively analysing the complementary views relative to a given reference class, is intended to allow, in a subsequent step, a final synthesis, which results from the joint consideration of the viewpoints corresponding to both poles A and Ā. In the present construction, the process of confronting the different perspectives relevant to an A/Ā duality is intended to build cumulatively, a more objective and comprehensive standpoint than the one, necessarily partial, resulting from taking into account those data that stem from only one of the two poles.

Further reading: Elements of dialectical contextualism

(c) Paul Franceschi

Posted in Glossary | Tagged , , , , , , , | Leave a comment

Glossary

Ambiguous images
Conflict resolution
Conflict resolution with matrices of concepts
Conflict types relating to matrices of concepts
Contextualism
Dialectical contextualism
Dialectical monism
Dialectical monism in ancient Aztec philosophy
Dialectical monism in Heraclitus
Dichotomic analysis
Dichotomic analysis applied to paradox resolution
Dualities
Dual poles
Instance of one-sidedness fallacy
Matrices of concepts
Maximisation
Minimisation
Bistable cognition
Bistable perception
Omission of the neutral
One-sidedness bias
Philosophical paradox as conflict
Polar contraries
Principle of dialectical indifference
Reference class
Reference class problem
Reference class problem in philosophical paradoxes
Reference class problem in the Doomsday argument
Reference class problem in Hempel’s paradox
Reference class problem in the Surprise examination paradox
System of taxa
Viewpoint of a duality
Viewpoint of a given pole

Posted in Glossary | Leave a comment

Differential Cognitive Treatment of Polythematic Delusions and Generalised Anxiety Disorder

640px-Panic-attackEnglish translation of a paper published in french under the title “Traitement cognitif différentiel des délires polythématiques et du trouble anxieux généralisé”, in the Journal de Thérapie Comportementale et Cognitive, 2011, vol. 21-4, pp. 121-125.

Schizophrenia is often associated with other physical and mental problems. Generalized anxiety disorder is notably one of the comorbid disorders which is often linked to schizophrenia. The association of polythematic delusions and of ideas resulting from generalized anxiety disorder complicates the exercise of the corresponding cognitive therapy, for the resulting ideas are most often inextricably intertwined. In what follows, we endeavour to propose a methodology for the differential treatment of polythematic delusions inherent to schizophrenia when combined with ideas originating from generalized anxiety disorder. We propose, with regard to the corresponding content of delusions, an analysis which allows under certain conditions, to separate the content associated with polythematic delusions and the one that relates to generalized anxiety disorder, in order to facilitate the exercise of the corresponding cognitive therapy.

line_1

Differential Cognitive Treatment of Polythematic Delusions and Generalised Anxiety Disorder

 

Generalized anxiety disorder is a comorbid disorder which is commonly associated with schizophrenia. Such co-morbidity is likely to render more complex and difficult the corresponding cognitive therapy. In what follows, we strive to provide a methodology to allow for a differential treatment of polythematic delusions inherent to schizophrenia when associated with generalized anxiety disorder. We describe then, based on the content of the corresponding delusions, an analysis which allows, under certain conditions, to separate the content relating to the polythematic delusions and the one that concerns generalized anxiety disorder, in order to facilitate the implementation of the corresponding cognitive therapies.

Schizophrenia and co-morbidity

One of the difficulties inherent in the treatment of schizophrenia is the frequent co-morbidity that relates to the disease. This comorbidity bears either on physical conditions, or other psychiatric disorders. A co-morbidity of schizophrenia with physical [Sim et al affections. 2006] or neuropsychiatric disorders such as Tourette’s syndrome [Kerbeshiana et al. 2009], has then been observed. It was also found co-morbidity with other psychiatric disorders, which is very common [Bermanzohn 2000]. A significant co-morbidity has been ascertained in particular with depression (25%) [Bressan et al. 2003, Kim et al. 2008] and obsessive-compulsive disorder (26.50%) [Berman et al. 1995 Guillem et al. 2009]. Similarly, comorbidity within the sphere of anxiety disorders turns out to be quite common [Cosoff & Hafner, 1998, Braga et al. 2004]. It was thus demonstrated high rates of comorbidity with agoraphobia (8.20%) [Goodwin et al. 2002], panic disorder (13.80%) [Pallanti et al. 2004], generalized anxiety disorder (GAD), social phobia (13.30%) [Tibbo et al. 2003] or a specific phobia (13.60%) [Goodwin et al. 2002]. However, the co-morbidity of schizophrenia with certain disorders, such as intermittent explosive disorder, seems to have been little studied.

The comorbidity of schizophrenia with other psychiatric disorders does not lack to pose several problems in the treatment of the disease. First, such comorbidity is a factor that makes it difficult to improve the health status of the patient [Sim et al. 2006]. Second, the comorbidity of schizophrenia with other psychiatric disorders raises some specific issues that are important for cognitive and behavioural therapy of schizophrenia. Thus, the frequent comorbidity of schizophrenia with one or more associated disorders, suggests that it might be useful to adapt the corresponding cognitive therapy. In this sense, it may be useful to distinguish cognitive therapy targeted to polythematic delusions, from the therapy related to the comorbid disorders encountered in the patient. In any event, the introduction of a differential treatment of schizophrenia and comorbid disorders has specific aspects that should be highlighted. Such differential treatment requires for the therapist that the different disorders are well defined and especially that the therapist can distinguish within the patient’s speech what is relevant to the specific disorder that he/she aims to treat. In this context, the association of two or more disorders does not fail to create some confusion, for the patient’s delusions are often inextricably linked to ideas that arise from the co-morbid disorder(s). Thus, in the words of the patient, it is worth distinguishing between what is actual symptoms of schizophrenia (essentially polythematic delusions) and what results from the associated comorbid disorders, such as: depression, TAG, body dysmorphic disorder, social phobia, special phobia. This complex situation has the effect of making more difficult the corresponding cognitive therapy.

The difficulties just mentioned apply especially when schizophrenia is associated in patients with GAD, for which a co-morbidity rate of 12% [Cosoff & Hafner 1998] and 16.70% [Tibbo et al. 2003] were found. We propose, in what follows, to interest ourselves in the comorbidity of schizophrenia and TAG, and to proceed to describe in detail a methodology for distinguishing among the patient’s delusions, the content resulting from polythematic delusions proper from what is inherent to the TAG.

Instances of differentiation: polythematic delusions and anxiogenous ideas

The association of the content of these delusional ideas met in schizophrenia and anxiogenous ideas inherent to TAG may take different forms. For ease of analysis, we will work to identify certain stereotyped forms, among the mixed ideas resulting from this association. We shall use the classically defined delusions (delusions of reference, of telepathy, of thought-projection, of influence, or of control) and anxiogenous ideas whose structure is that of the projection of a negative future event. Let us consider then the mixed ideas likely to be encountered in the context of the association of polythematic delusions associated with schizophrenia and GAD (with the following abbreviations: R for reference, T for telepathy, P for thought-projection, I for influence, C for control):

(R1)

Next week, TV presenters will again talk about me”.

(T1)

I am sure that in five minutes, the neighbour will again comment on my thoughts”.

(P1)

I am sure that soon, people in the street will again start yelling because they are disturbed by my thoughts”.

(I1)

Tomorrow, I will again create an accident, because of the disruption that I create in others with my bad mood”.

(C1)

I am sure that when they will arrive, the neighbours will still make me break things by controlling me”.

These are mental constructs that combine both delusions which are specific to schizophrenia and anxiety ideas resulting from TAG (the structure of the latter being that of the anticipation of the occurrence of a future event of a negative nature). It is worth at this stage determining the structure of these mixed ideas in order to highlight what constitutes polythematic delusions proper and what is inherent in the TAG. Thus, in (R1) is contained, first, the delusion that the media talk about the patient, which is an instance of the delusion of reference. Second, the expectation that a negative event will occur, i.e. the media will speak again about the patient, is also present in (R1). Such an anticipation on a future event of a negative nature, has a special structure, which consists in the projection into the future of the occurrence of a negative event concerning the patient, even in the absence of an objective basis. This is one of the manifestations of the role played in TAG by expectations on indeterminate situations related to future events [Butler & Mathews 1987]. Most often, the patient considers a future event as certain, even though the probability of the event in question’s occurrence is much lower. Such anxiogenous idea has the structure below [Franceschi 2008a] (the patient’s anxiogenous idea occurs at time T0, with T0 <T1):

(A)

at time T1, the event E of a negative nature, will occur

anxiogenous idea

Given the above, we can now decompose the mixed idea (R1) in two separate ideas i.e. on the one hand, the delusion of reference and on the other hand, the projection of a negative future event:

(R)

Television and the media speak about me”

delusion of reference

(AR)

at time T1 (Next week) the event E (The presenters de television will speak about me”) of a negative nature, will occur

mixed anxiogenous idea

At this stage, it is now possible to apply a principle of cognitive therapy specific to TAG to the resulting anxiogenous mixed idea, by considering alternative hypotheses to the occurrence of the negative event, by notably considering the hypothesis that other events, of a positive nature, may occur. It also turns out that the same analysis can be applied to mixed propositions (T1), (P1), (I1) and (C1), in the following way:

(T)

The neighbours know the least of my thoughts”

delusion of telepathy

(AT)

at time T1 (“by five minutes”) the event E (“the neighbour will comment on my thoughts”) of a negative nature, will occur

mixed anxiogenous idea

(P)

People react according to what I think and start screaming”

thought projection delusion

(AP)

at time T1 (“in a moment”) the event E (“people in the street will begin to cry because they are disturbed by my thoughts”) of a negative nature, will occur

mixed anxiogenous idea

(I)

People are disturbed by my thoughts”

delusion of influence

(AI)

at time T1 (“tomorrow”) the event E (“I’m going to cause an accident, because of the disruption that I create in others with my bad mood”) of a negative nature, will occur

mixed anxiogenous idea

(C)

I have feelings and emotions according to what people do”

delusion of control

(AC)

at time T1 (“when they will arrive) the event E (“the neighbours will make me break things by controlling me) of a negative nature, will occur

mixed anxiogenous idea

However, it turns out that the application of a principle cognitive therapy inherent to GAD to the mixed anxiety ideas resulting from the above analysis, is likely to present a problem. Indeed, a questioning of the form “Is it certain that the television will still talk to you tomorrow?” or “Isn’t it possible that television will not speak about you tomorrow? may give the impression that the therapist adheres to the patient’s delusional ideas of reference, which might be likely to strengthen them. To avoid this problem, it may be useful to eliminate the delusional content in the mixed anxiety-provoking idea. For once such removal is done, the principle of cognitive therapy inherent to GAD can then be applied directly to the residual anxiety idea without the aforementioned drawback begin faced. The methodology we propose to transform the mixed anxiety idea into a pure anxiety idea is based on the process of formation of the patient’s delusions. The development of the delusional ideas (R) (T) (P), (I) and (C) is carried starting from the primary delusional arguments, based on the attribution by the patient of a causal relationship when faced with the occurrence of two quasi-simultaneous events [Hemsley 1992 Franceschi 2008b]. Such primary delusional arguments have the following structure (the symbol denotes the conclusion):

(R1)

in T1 I was drinking an aperitif

premiss1

(R2)

in T2 the presenter of the show said: “Stop drinking !”

premiss2

(R3)

in T2 the presenter of the show said: “Stop drinking !” because in T1 I was drinking an aperitif

conclusion

(T1)

in T1 I thought of Jacques “What an idiot !”

premiss1

(T2)

in T2 I heard Jacques say: “Enough!”

premiss2

(T3)

in T2 I heard Jacques say, “Enough! “Because in T1 I thought of him,”What an idiot!”

conclusion

(P1)

in T1 I thought of someone who passed on the street “is badly dressed!”

premiss1

(P2)

in T2 I heard someone who passed on the street shout

premiss2

(P3)

in T2 I heard someone who passed in the street screaming because in T1 I thought of of him “He’s badly dressed!”

conclusion

(I1)

in T1 I had a very bad mood

premiss1

(I2)

in T2 I heard there was a car accident in the street

premiss2

(I3)

in T2 there was a car accident in the street because in T1 I was in a very bad mood

conclusion

(C1)

in T1 the neighbour has moved

premiss1

(C2)

in T2 I broke a glass

premiss2

(C3)

in T2 I broke a glass because in T1 the neighbour has moved

conclusion

Such a structure from primary delusional arguments reveals that in instances of primary arguments of reference, of telepathy, of thought projection and of influence, an internal event to the patient (thought, emotion, feeling, action) slightly precedes an external event, in the following manner:

(α1)

in T1 the internal event E1 has occurred

premiss1

(α2)

in T2 the external event E2 has occurred

premiss2

(α3)

in T2 the external event E2 has occurred because in T1 the internal event E1 has occurred

conclusion

In contrast, at the level of the instances of primary arguments of control, it is the event which is external to the patient that precedes an internal event:

(β1)

in T1 the external event E1 has occurred

premiss1

(β2)

in T2 the internal event E2 has occurred

premiss2

(β3)

in T2 the internal event E2 has occurred because in T1 the exernal event E1 has occurred

conclusion

In this context, the elimination of the delusional content from mixed delusions can then be performed. For this, one eliminates from the mixed anxiogenous idea the mere idea of causality, by only retaining the event which constitutes the object of the anxiogenous idea, in the following way:

(AI)

at time T1 (“tomorrow”) the event E (“I’m going to create an accident, because of the disturbance that I create in others with my bad mood”) of a negative nature, will occur

mixed anxiogenous idea

(BI)

at time T1 (“tomorrow”) the event E (“there will be an accident in the street”) of a negative nature, will occur

pure anxiogenous idea

The methodology used here is thus to eliminate the delusional content in the speech of the patient and replace it with factual content, to which we can then apply a classical form of cognitive therapy for GAD, based on the consideration of alternative hypotheses: “Isn’t it possible that no accident occurs on the street tomorrow? “(I); “Isn’t it possible that tomorrow you could not break your glass? “(C); “Can’t we consider that no passer-by shouts in the street just now? “(P). Such formulation has thus the advantage of enabling the direct implementation of the very principle of the cognitive therapy inherent to TAG without facing the above-mentioned drawback.

Conclusion

In cognitive therapy of schizophrenia raises the question of the appropriate treatment of comorbid disorders associated with it. Regarding particularly GAD, which is often associated with schizophrenia, several questions arise as well. The first question is thus whether it is appropriate that two different therapists take care one of the therapy for GAD, and the other of the therapy for delusions. A second question, in this context, is whether it is better to implement the GAD therapy before that targeted at delusions [17,18]. The answer to these questions is beyond the scope of this study, but it may be important in the strategy implemented for cognitive therapy of schizophrenia.

At this point, it turns out that the usefulness of the above analysis it that it allows for simplifying the cognitive therapy in the case where there is a comorbid schizophrenia and TAG, in that it separates in the content of the original complex discourse of the patient, what is delusions proper and what is inherent in the TAG. This permits the isolation of a simplified discourse, to which can then be applied independently either the principle inherent to cognitive therapy for TAG, or the one that relates to delusions. This results in a second interest, in that it can help, if necessary, to two different therapists to take care of each cognitive therapy for GAD and delusions. Finally, a third interest is that it allows to make use of specific strategies. One such strategy is for example to implement cognitive therapy for GAD before cognitive therapy delusions. Is it better in effect when there exists in the patient a co-morbidity between schizophrenia and TAG, to implement cognitive therapy for GAD before, after or at the same the therapy for delusions? The above discussion does not lead to prefer one or other strategic option, but they can still be reformulated in terms of testable hypotheses. The first testable hypothesis that emerges is that the implementation of cognitive therapy for GAD, irrespective of cognitive therapy for delusions, could have a positive effect on symptoms of schizophrenia themselves. The second testable hypothesis is that the resulting cognitive therapy for delusions themselves could be more effective if it was implemented after a cognitive therapy for GAD has been achieved and demonstrated effective.

References

[1] Berman, I., Kalinowski, A., Berman, S.M., Lengua, J., Green, A.I. Obsessive and compulsive symptoms in chronic schizophrenia. Comprehensive Psychiatry 1995; 36: 6-10.

[2] Bermanzohn P.C., Porto L., Arlow P.B., Pollack S., Stronger R., Siris S.G. Hierarchical diagnosis in chronic schizophrenia: a clinical study of co-occurring syndromes. Schizophrenia Bulletin 2000; 26: 517–525.

[3] Braga R., Petrides G., Figueira I. Anxiety Disorders in Schizophrenia, Comprehensive Psychiatry 2004; 45(6): 460-468.

[4] Bressan, R.A., Chaves, A.C., Pilowsky, L.S., Shirakawa, I., Mari, J.J. Depressive episodes in stable schizophrenia: critical evaluation of the DSM-IV and ICD-110 diagnostic criteria. Psychiatry Research 2003; 117: 47–56.

[5] Butler G et Mathews A. Anticipatory anxiety and risk perception. Cognitive Therapy and Research 1987; 11: 551-565.

[6] Cosoff S.J., Hafner R.J. The prevalence of co-morbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder. Australian and New Zealand Journal of Psychiatry 1998; 32: 67-72.

[7] Franceschi P. Théorie des distorsions cognitives : application à l’anxiété généralisée, Journal de Thérapie Comportementale et Cognitive 2008a; 18: 127-131. English translation.

[8] Franceschi P. Une défense logique du modèle de Maher pour les délires polythématiques. Philosophiques 2008b; 35(2): 451-475. English translation.

[9] Goodwin R., Lyons J., McNally R. Panic attacks in schizophrenia. Schizophrenia Research 2002; 58: 213-220.

[10] Guillem F., Satterthwaite J., Pampoulova T., Stip E. Relationship between psychotic and obsessive compulsive symptoms in schizophrenia. Schizophrenia Research 2009; 115: 358-62.

[11] Hemsley D. Disorders of perception and cognition in schizophrenia. Revue européenne de Psychologie Appliquée 1992; 42(2): 105-114.

[12] Kerbeshiana J., Pengb C.Z., Burd L. Tourette syndrome and comorbid early-onset schizophrenia. Journal of Psychosomatic Research 2009; 67: 515-523.

[13] Kim S.W., Kim S.J., Yoon B.H., Kim J.M., Shin I.S., Hwang M., Yoon J.S. Diagnostic validity of assessment scales for depression in patients with schizophrenia. Psychiatry Research 2006; 144: 57-63.

[14] Kingdon D. et Turkington D. Cognitive-behavioural Therapy of Schizophrenia, New York: Guilford, 1994.

[15] Kingdon, D. et Turkington, D. Cognitive Therapy of Schizophrenia, New York, London: Guilford, 2005.

[16] Pallanti S., Quercioli L., Hollander E. Social anxiety in outpatients with schizophrenia: a relevant cause of disability. Am J Psychiatry 2004; 161: 53-58.

[17] Sim K., Chan Y.H., Chua T.H., Mahendran R., Chong S.A., McGorry P. Physical comorbidity, insight, quality of life and global functioning in first episode schizophrenia: A 24-month, longitudinal outcome study. Schizophrenia Research 2006; 88: 82-89.

[18] Tibbo P., Swainson J., Chue P., LeMelledo JM. Prevalence and relationship to delusions and hallucinations of anxiety disorders in schizophrenia. Depress Anxiety 2003;17: 65-72.

Posted in Psycho-pathological Philosophy | Tagged , , , , , , , , , , , , , , , | Leave a comment